Healthcare Provider Details

I. General information

NPI: 1215804968
Provider Name (Legal Business Name): TALISA SNOW APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 S MEDICAL PARK DR
FISHERSVILLE VA
22939-2333
US

IV. Provider business mailing address

PO BOX 388
FISHERSVILLE VA
22939-0388
US

V. Phone/Fax

Practice location:
  • Phone: 540-245-7350
  • Fax: 540-245-7360
Mailing address:
  • Phone: 540-932-5275
  • Fax: 540-932-5875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024195091
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0024195091
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: